Provider Demographics
NPI:1548066210
Name:LEONARD, BERNADETTE L
Entity type:Individual
Prefix:
First Name:BERNADETTE
Middle Name:L
Last Name:LEONARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3710 CRESWICK CIR UNIT G
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32065-5659
Mailing Address - Country:US
Mailing Address - Phone:905-305-2702
Mailing Address - Fax:904-688-7286
Practice Address - Street 1:3710 CRESWICK CIR UNIT G
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32065-5659
Practice Address - Country:US
Practice Address - Phone:905-305-2702
Practice Address - Fax:904-688-7286
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter